Basic Information
Provider Information
NPI: 1477630978
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: ARTI
MiddleName: S.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 285 DAVIDSON AVE
Address2: SUITE 204
City: SOMERSET
State: NJ
PostalCode: 088734153
CountryCode: US
TelephoneNumber: 7322711400
FaxNumber: 7322713544
Practice Location
Address1: 285 DAVIDSON AVE
Address2: SUITE 204
City: SOMERSET
State: NJ
PostalCode: 088734153
CountryCode: US
TelephoneNumber: 7322711400
FaxNumber: 7322713544
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 08/05/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMA0803500NJY Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X25MA08035000NJN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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